New Patient Forms

There is currently a waiting list for new patients- please message Quinn to get on the list to schedule a remote appointment.

REQUIRED FORMS:

1. Patient Intake Form

I will send you a digital version to complete once a new patient appointment is scheduled

All patients please read this HIPAA Notice of Privacy Practices Form.
As required by law, it is available for you to read and to print should you desire to do so. There is also a hard copy of this in the office to read.

In addition, I will send digital copies to complete of the following forms:

2. Patient Registration Form

3. Consent Forms

4. Medical Records Release Consent (optional).

All Medicare and Medicaid patients please complete:

Medicare Private contract / Medicare Opt Out

We look forward to seeing you soon!